Checklist of Possible Indicators of Abuse and Neglect

• Depends on location of injuries, severity, circumstances, frequency, and age of child
  
• On face, lips, mouth, neck, wrists, ankles
• On both eyes or cheeks (accidents usually injure only one side of the face)
• Clustered, forming patterns reflecting the shape of an article (child was struck with something)
• In the form of a hand (grab mark) on several different surface areas of skin
• On torso, back, buttocks, thighs
• In various stages of healing regularly appearing after absence, weekend, vacation

Note: People of color such as African/American and Asian infants and children may have areas of darker pigment on their skin (known as Mongolian spots) which are not bruises, but rather a type of birthmark.

Depends on location of injuries, severity, circumstances, frequency, and age of child

• To mouth, lips, gums, eyes
• On back or arms, legs or torso

• Cigar, cigarette, especially on soles, palms, back, buttocks
• Scalding water immersion (sock-like, glove-like, doughnut shaped on buttocks or genitalia)
• Patterned, like curling iron, electric iron, burner, etc.
• Rope burns on arms, legs, neck, torso

• To jaw and nasal structures
• To skull, facial structures
• Skeletal trauma accompanied by other injuries, such as dislocations
• Multiple or spiral fractures
• Fractures 'accidentally' discovered in the course of an exam or in various stages of healing

• Subdural hematoma (a hemorrhage beneath the outer covering of the brain, due to severe hitting or shaking)
• Retinal hemorrhage or detachment, due to shaking 'whiplash shaken baby syndrome'
• Eye injury (such as black eye)
• Tooth or frenulum (under the tongue) injury
• Absence of hair and/or hemorrhaging beneath the scalp, caused by vigorous hair pulling

• Munchausen Syndrome by Proxy is a pattern of parental behavior in which a child is frequently brought into medical care with symptoms suggestive of parentally induced or fabricated illness. An example might be a parent seeking attention by repeatedly causing a child to ingest quantities of laxatives sufficient to cause diarrhea and dehydration, thus requiring hospitalization.